亚低温治疗对高血压脑出血微创血肿清除术后患者血清炎性因子及血管活性物质的影响

Effect of mild hypothermia therapy on inflammatory factors and vasoactive substances in patients with hypertensive intracerebral hemorrhage after minimally invasive hematoma evacuation

目的探讨亚低温治疗对高血压脑出血患者微创血肿清除术后血清炎性因子及血管活性物质的影响。方法选择2013年1月—2015年6月莱芜市人民医院神经外科收治的118例高血压脑出血患者为研究对象,根据入院时间按照奇偶数号随机分为观察组和对照组各59例。对照组行微创颅内血肿清除术,观察组采用亚低温联合微创颅内血肿清除术治疗。比较2组血清炎性因子、血管活性物质及预后情况。结果与术前比较,2组术后血清肿瘤坏死因子-α(TNF-α)、白细胞介素石(IL-6)水平,C-反应蛋白(CRP)含量均明显降低,且观察组术后低于对照组(t=70.616、66.172、51.251,P<0.01);与术前比较,术后2组内皮素(ET)、血管升压素(AVP)含量均明显降低,且观察组术后低于对照组(t=3.529、6.171,P<0.05);随访6个月,观察预后良好率38.98%明显高于对照组13.56%(χ~2=9.844,P<0.01)。结论亚低温治疗有助于改善高血压脑出血患者微创血肿清除术后预后,可能与降低高血压脑出血患者炎性症状、调节血管活性物质、促进受损神经功能恢复等因素有关。

Objective To study effect of inflammatory cytokines and vasoactive substances of hypothermia therapy for patients with hypertensive cerebral hemorrhage after intracranial hematoma evacuation.Methods One hundred and eighteen patients with hypertensive cerebral hemorrhage form January 2013 to June 2015 were divided into observation group and control group,the control group given minimally intracranial hematoma evacuation,the observation group given hypothermia therapy combined with minimally intracranial hematoma evacuation,then serum inflammatory cytokines,vasoactive substances,prognosis were compared between the two groups.Results 7 d after surgery,the observation group＆#39;＆#39;s serum TNF-α,IL-6,CRP were significantly lower than control group（t=70.616,t=66.172,t=51.251,P＆lt;0.01）;ET,AVP were significantly lower than control group（t=3.529,t=6.171,P＆lt;0.05）;Followed up for 6 months,the observation group prognosis good rate was 38.98%,which was significantly higher than control group＆#39;＆#39;s 13.56%（x2=9.844,P＆lt;0.05）.Conclusion Hypothermia therapy helps to improve the prognosis of patients with hypertensive cerebral hemorrhage,may be related to lower serum inflammatory cytokines,regulating vascular active substances,promoting the damaged nerve functional recovery.